Provider Demographics
NPI:1205459492
Name:OUTCOMES CLINIC LLC
Entity type:Organization
Organization Name:OUTCOMES CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DANZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-798-8781
Mailing Address - Street 1:1314 S KING ST STE 1255
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1947
Mailing Address - Country:US
Mailing Address - Phone:808-744-2002
Mailing Address - Fax:737-221-5808
Practice Address - Street 1:1314 S KING ST STE 1255
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1947
Practice Address - Country:US
Practice Address - Phone:808-798-8781
Practice Address - Fax:877-308-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty